Nevin Manimala

Psychol Health Med. 2024 Nov 29:1-17. doi: 10.1080/13548506.2024.2433545. Online ahead of print.

ABSTRACT

Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one of the potential adverse effects of PPD among mothers in the postpartum period, but this association has not been adequately studied especially in low resource settings. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda. We conducted a facility based cross-sectional study of 309 mothers between 6th week to 6th month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers. The study established that PPD prevalence of PPD among mothers of 6th weeks to 6th months postpartum period in Mbarara was 40.5% (95% CI: 35.1-45.1%) and it was statistically significantly associated with diabetes mellitus in mothers between 6 weeks and 6 months postpartum. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD. Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes as compared to those without PPD (aOR = 3.0, 95% CI: 1.62-5.74, p = 0.001). Mothers with PPD between 6 weeks and 6 months postpartum are more likely to have diabetes mellitus as compared to those without PPD. Well-designed prospective analytical studies are needed to conclude on the risk of diabetes mellitus in relation to PPD. Early screening of PPD may be considered in postpartum mothers.

PMID:39611342 | DOI:10.1080/13548506.2024.2433545

J Orthod. 2024 Nov 29:14653125241283053. doi: 10.1177/14653125241283053. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the space closure, root resorption and canine angulation during en-masse retraction of the labial segment after extraction of first premolars with or without interseptal bone reduction distal to the maxillary canines.

DESIGN: A single-centre, parallel randomised control trial included 16 participants with a mean age of 21.5 years. Participants were allocated into treatment groups using blocked randomisation, and blinding was employed for outcome assessors and data analysts.

INTERVENTIONS: The control group consisted of eight participants who underwent therapeutic extraction of maxillary first premolars, while the experimental group included eight participants who underwent interseptal bone reduction immediately after premolar extraction. En-masse retraction was performed using conventional friction mechanics with absolute anchorage in both groups.

OUTCOMES: Measurements of space closure were conducted over 3 consecutive months during retraction. The time taken for total space closure was recorded. Cone-beam computed tomography scans were taken before and 3 months after retraction to assess root resorption and canine angulation.

RESULTS: The experimental group demonstrated a significant increase in the rate of en-masse retraction compared to the control group over 3 months (mean difference [MD] = 1.09 mm, 95% confidence interval [CI] = 0.78-1.40), with an overall space closure rate of MD 0.26 mm/month (95% CI = 0.17-0.34). However, these changes were of minimal clinical significance. The change in canine angulation (MD = 4.50°, 95% CI = -1.61-10.61) did not exhibit statistical significance. Substantial root resorption was observed in six maxillary anterior teeth, with no difference between the groups.

CONCLUSION: Interseptal bone reduction is a minimally invasive surgical technique, resulting in a notably accelerated rate of en-masse retraction in the experimental group over 3 months. However, despite the statistical significance, the clinical impact on overall space closure was minimal, with a difference of only 0.26 mm/month observed between the groups. Interseptal bone reduction did not affect the change in canine angulation and root resorption.

PMID:39611308 | DOI:10.1177/14653125241283053

Eur Heart J Cardiovasc Pharmacother. 2024 Nov 28:pvae092. doi: 10.1093/ehjcvp/pvae092. Online ahead of print.

NO ABSTRACT

PMID:39611306 | DOI:10.1093/ehjcvp/pvae092

Biom J. 2024 Dec;66(8):e70014. doi: 10.1002/bimj.70014.

ABSTRACT

We develop a variable selection method for interactions in regression models on large data in the context of genetics. The method is intended for investigating the influence of single-nucleotide polymorphisms (SNPs) and their interactions on health outcomes, which is a $p\gg n$ problem. We introduce cross leverage scores (CLSs) to detect interactions of variables while maintaining interpretability. Using this method, it is not necessary to consider every possible interaction between variables individually, which would be very time-consuming even for moderate amounts of variables. Instead, we calculate the CLS for each variable and obtain a measure of importance for this variable. Calculating the scores remains time-consuming for large data sets. The key idea for scaling to large data is to divide the data into smaller random batches or consecutive windows of variables. This avoids complex and time-consuming computations on high-dimensional matrices by performing the computations only for small subsets of the data, which is less costly. We compare these methods to provable approximations of CLS based on sketching, which aims at summarizing data succinctly. In a simulation study, we show that the CLSs are directly linked to the importance of a variable in the sense of an interaction effect. We further show that the approximation approaches are appropriate for performing the calculations efficiently on arbitrarily large data while preserving the interaction detection effect of the CLS. This underlines their scalability to genome wide data. In addition, we evaluate the methods on real data from the HapMap project.

PMID:39611288 | DOI:10.1002/bimj.70014

Euro Surveill. 2024 Nov;29(48). doi: 10.2807/1560-7917.ES.2024.29.48.2400759.

ABSTRACT

We analysed trends in new HIV diagnoses and factors contributing to late diagnosis among migrants in countries in the European Union (EU)/European Economic Area (EEA) from 2014 to 2023. Of the total reported HIV diagnoses, 45.9% were in migrants, with 13.3% born in EU/EEA countries and 86.7% in non-EU/EEA countries. Late diagnosis was observed in 52.4% of migrants, particularly among non-EU/EEA migrants with heterosexual transmission, regardless of sex. Improved HIV prevention and testing strategies are essential for at-risk migrant populations.

PMID:39611209 | DOI:10.2807/1560-7917.ES.2024.29.48.2400759

Euro Surveill. 2024 Nov;29(48). doi: 10.2807/1560-7917.ES.2024.29.48.2400138.

ABSTRACT

BackgroundLate HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.AimTo determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.MethodsThis multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019-21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.ResultsAmong 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.ConclusionMOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.

PMID:39611208 | DOI:10.2807/1560-7917.ES.2024.29.48.2400138

Euro Surveill. 2024 Nov;29(48). doi: 10.2807/1560-7917.ES.2024.29.48.2400347.

ABSTRACT

BackgroundGlobal data highlight the disproportionate burden of HIV and sexually transmitted infections (STIs) among transgender individuals. However, scant data exist for both transgender and non-binary individuals in European HIV/STI surveillance.AimTo assess self-reported prevalence of HIV and bacterial STIs (syphilis, gonorrhoea, chlamydia) in the past 6 months among transgender and non-binary individuals, comparing the likelihoods of recent STIs between groups.MethodsUsing data from the cross-sectional PROTECT survey conducted in 20 European countries from October 2023 to April 2024, we analysed a subset of 452 participants, 178 transgender and 274 non-binary individuals. Logistic regression was used to compare the risk of each recent bacterial STI, and Poisson regression to compare the risk of the number of recent STIs.ResultsAmong transgender individuals, 5 (2.8%) self-reported HIV infection, and recent STI prevalence was 6.7% for syphilis, 15.6% for gonorrhoea and 19.6% for chlamydia. For non-binary individuals, 15 (5.5%) self-reported HIV infection and recent STI prevalence was 15.0% for syphilis, 18.7% for gonorrhoea and 20.8% for chlamydia. Non-binary individuals had significantly higher risk for syphilis (aOR: 1.81; 95% CI: 1.01-4.05) and multiple recent STIs (aOR: 1.46; 95% CI: 1.11-1.91) compared with transgender individuals.ConclusionWhile both transgender and non-binary individuals showed high self-reported prevalence of HIV and bacterial STIs, non-binary individuals showed greater prevalence of STIs, particularly syphilis. Efforts aimed at HIV/STI prevention and surveillance should encourage inclusion of those who identify as non-binary and other gender-diverse individuals alongside transgender individuals to enhance the provision of tailored prevention and treatment services in Europe.

PMID:39611207 | DOI:10.2807/1560-7917.ES.2024.29.48.2400347

Rheumatol Adv Pract. 2024 Nov 5;8(4):rkae135. doi: 10.1093/rap/rkae135. eCollection 2024.

ABSTRACT

OBJECTIVES: Real-world evidence is needed to inform treatment strategies for patients with PsA and axial SpA (axSpA) who have non-musculoskeletal manifestations (NMMs), various risk factors and comorbidities. International collaboration is required to ensure statistical power and to enhance generalizability. The first step forward is identifying which data are currently being collected. Across 17 registries participating in the European Spondyloarthritis Research Collaboration (EuroSpA), we aimed to map recording practices for NMMs, comorbidities and safety outcomes in patients with PsA and axSpA.

METHODS: Through a survey with 4,420 questionnaire items, we explored the recording practices of 58 pre-defined conditions (i.e. NMMs, comorbidities and safety outcomes) covering 10 disease areas. In all registries we mapped for each condition whether it was recorded, the recording procedure and the potential to identify it through linkage to other national registries.

RESULTS: Conditions were generally recorded at entry into the registry and clinical follow-up visits using a pre-specified list or a coding system. Most registries recorded conditions within the following disease areas: NMMs (number of registries, n = 15-16), cardiovascular diseases (n = 10-14), gastrointestinal diseases (n = 12-13), infections (n = 10-13) and death (n = 14). Nordic countries had the potential for data linkage and generally had limited recording of conditions in their registry, while other countries had comprehensive recording practices.

CONCLUSION: A wide range of conditions were consistently recorded across the registries. The recording practices of many conditions and disease areas were comparable across the registries. Our findings support the potential for future collaborative research.

PMID:39611201 | PMC:PMC11604170 | DOI:10.1093/rap/rkae135

J Clin Orthop Trauma. 2024 Nov 7;59:102800. doi: 10.1016/j.jcot.2024.102800. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is expected to relieve pain and reduce the use of analgesics in patients with advanced knee osteoarthritis. However, in some cases, there is no relief in the pain of the patients and the use of analgesics continues. The aim of this study was to compare analgesic consumption one year before and after TKA in the same patient group and to evaluate whether there is a decrease in analgesic consumption after TKA.

METHOD: The cumulative amounts of analgesia used by the patients in the one-year periods before and after the operation were checked from the automated patient records system and the national systems showing drug prescriptions. The dosages of all the analgesics used in the one-year periods before and after the operation were calculated and converted to oral morphine equivalents (OME). The demographic data of the patients, cumulative OME and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used in the assessment.

RESULTS: It was observed that there was a statistically significant improvement in Womac scores after the treatment compared to the pre-treatment. Although the mean amount of analgesics decreased compared to pre-treatment, it was not statistically significant. Also, age and preoperative analgesic use were found to be the two most important factors in relation to total postoperative analgesic consumption.

CONCLUSION: The results of this study indicate that there may not be a substantial reduction in the use of analgesic by patients within the first year after TKA. Furthermore, the age and preoperative analgesic use were identified as the two primary factors influencing postoperative analgesic consumption.

LEVEL OF EVIDENCE: Retrospective Cohort Study.

PMID:39611163 | PMC:PMC11600055 | DOI:10.1016/j.jcot.2024.102800

Front Cell Infect Microbiol. 2024 Nov 14;14:1439143. doi: 10.3389/fcimb.2024.1439143. eCollection 2024.

ABSTRACT

BACKGROUND: The accurate and sensitive diagnosis of intracranial infection continues to pose a critical challenge. This study aimed to probe into the clinical value of heparin binding protein (HBP) in bacterial intracranial infection.

METHODS: Patients suspected of having bacterial intracranial infection and admitted to Shanghai General Hospital from November 2021 to November 2023 were selected as study subjects and divided into an infected group and a non-infected group. The receiver operating characteristic (ROC) curve was constructed to compare the diagnostic accuracy of HBP, procalcitonin (PCT), and C-reactive protein (CRP), as well as their value in differentiating Gram-positive bacteria and Gram-negative bacterial infections.

RESULTS: According to the results of bacterial identification, the infected groups were divided into a Gram-negative bacteria group (n = 142) and a Gram-positive bacteria group (n = 128), while the non-infected group comprised 120 patients after neurosurgery involving dura opening. Statistically significant differences were observed in the levels of HBP, PCT, and CRP between the infected group and the non-infected group (all p< 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of HBP was 0.935, and the AUCs of PCT and CRP were 0.931 and 0.863, respectively. In the comparison of HBP, PCT, and CRP levels in the Gram-negative bacteria and Gram-positive bacteria groups, the AUCs were 0.816, 0.602, and 0.591, respectively. When the cutoff value of HBP was 72.34 ng/mL, its specificity reached 96.1% and its sensitivity was 57.8%. When PCT and CRP levels were less than 1.67 ng/mL and 23.12 ng/mL, respectively, both the sensitivity (52.3%, 53.1%) and specificity (66.9%, 59.9%) were relatively low.

CONCLUSION: HBP, PCT, and CRP can be employed as diagnostic indicators for bacterial intracranial infection. HBP (>72.34 ng/mL) can act as an important index for the diagnosis of Gram-negative bacteria in patients with intracranial infection.

PMID:39611102 | PMC:PMC11602516 | DOI:10.3389/fcimb.2024.1439143